Political debate continues over options to fix Iowa's Medicaid system

MGN Online

Democrats calling for a federal investigation into Iowa's privatized Medicaid system and ongoing reports of problems were delivered to regulators in the form of a letter last week. Critics say the current system is not serving patients well and not saving the state money compared to the old public system, also know as fee for service.

"These are federal dollars, taxpayer dollars paying for this." Said Hiawatha Senator Liz Mathis. "I think not only do they have a responsibility to make sure they make managed care work in Iowa, but they have a responsibility to listen to the people who are receiving the services and those who are providing the care."

Sen. Mathis and other democrats believe if the Centers for Medicare and Medicaid Services were to see the issues with their own eyes, there would be more pressure put on state operators. Right now, there is just one private provider accepting new subscribers in Iowa. Friday, the Iowa Department of Human Service said Amerigroup would resume accepting new clients in May. Mathis says she's heard talk of a third provider considering joining the system, but no formal negotiations have been announced by Iowa DHS.

"There are some Republicans that are in agreement and they are willing to listen." Says Sen. Mathis. Iowa Governor Kim Reynolds, who supported the decision by then-Governor Terry Branstad to privatize the Medicaid system without legislative approval, says Iowa cannot go back to the way things were.

"We cannot go back to fee for service. I can't look parents in the eyes who have children with complex needs." Governor Reynolds believes the most intensive and long term patients are better served by the current system. The Governor has repeatedly admitted mistakes were made during the roll out but maintains she's ready to work with lawmakers to make the needed modifications.

As for Senator Mathis, she provided some constructive criticism of the Governor's role in the debate so far. "I think she's become more active, I don't know how active. I know she has put together a round table." But Sen. Mathis wants that effort to become a bipartisan one. "Of course it's closed to Democrats, she hasn't asked us to be a part of that round table."

But the Governor says she is open to ideas from the other sides of the aisle. "I know Senator Mathis very well, and I've set aside time for legislators to come down and speak to me." Governor Reynolds says she's happy to work with Democrats to find ideas that can be turned into meaningful legislation.

But with this year's legislative session nearing the halfway mark, there's a lot of work to do in order to send a bill to the Governor's desk. "The clock is ticking," Sen. Mathis warns. "I'm optimistic that there will be fixes to things, I think maybe the ideas that I'd like to see sooner rather than later is going to come later."

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